About Substance Use Disorder Clinical Care
- Substance Use Disorder Clinical Care (previously known as ASAP-Rehab) is the Army's model for providing outpatient substance use disorder and other behavioral health care in an integrated, unit-aligned, and co-located manner.
- SUDCC includes assessment, treatment, and aftercare, for service members and other beneficiaries within an integrated medical and behavioral health model to enhance health and readiness. The fully- integrated, unit-aligned, co-located comprehensive substance use disorder treatment services utilize national best practices to optimize care delivery, treatment outcomes, and force conservation for service members and other beneficiaries.
- The SUDCC provides substance use disorder treatment as part of a comprehensive plan to address total BH needs and integrates care to maximize the opportunity for a rapid and successful recovery and return to full readiness status, through:
- Integrating SUDCC with the BHSOC (Behavioral Health System Of Care). Unit-align and co-locate care to improve access and continuity of care. Utilizing Behavioral Data Portal (BHDP) to track and improve substance use disorder clinical outcomes. Utilizing Behavioral Health Service Line (BHSL) capabilities and performance tools to improve value. Partnering with command teams to ensure safety and maintain readiness.
- Continuing to transform from a program-oriented model to a recovery-oriented model.
- Please contact your local Military Treatment Facility, Behavioral Health Department, or TRICARE if you would like more information on early interventions and/or treatment for substance -use-related issues.
- Classification Opiates are Central Nervous System (CNS) Depressants that are derived from the poppy plant and also produced synthetically. The most common opiates are: opium, fentanyl, heroin, oxycodone, morphine, and codeine. Opium is the least potent of the opioids. They are commonly used for medical purposes but also used illegally. Many of the prescription pain killers on the market today contain opiates.
- Usage/Effects Opiates can be snorted, smoked, injected, and eaten. Some short-term effects resulting from opiate use include itchy skin, impaired vision, altered mental process, and overdose/death. The long-term effects include severe weight loss, collapsed veins, lung damage, kidney damage, brain damage, liver damage, immune system damage, and death.
- Classification Depressants that produce sedation, induce sleep, relieve anxiety and prevent seizures. Available in prescription pills, syrup and injectable preparation. Prescribed as Valium®, Xanax®, Restoril®, Ativan®, Klonopin®.
- Usage/Effects Benzodiazepines are typically taken orally or crushed and snorted. Effects include feeling calm, euphoria (the high), vivid or disturbing dreams, amnesia, hostility, irritability. Overdose may be fatal. Signs: shallow respiration, clammy skin, dilated pupils, weak and rapid pulse, coma.
- Classification: Counterfeit pills are fake medications that have different ingredients than the actual medication. They may contain no active ingredient, the wrong active ingredient, or have the right ingredient but in an incorrect quantity, which can make them difficult to classify because it’s unclear (without laboratory testing) what is actually in them. Counterfeit pills may contain lethal amounts of fentanyl or methamphetamine and are extremely dangerous because they often appear identical to legitimate prescription pills, and the user is likely unaware of how lethal they can be.
- Usage: Counterfeit pills are commonly consumed orally, crushed and snorted nasally, or mixed with other substances and injected intravenously. They are especially dangerous because people think they are purchasing legitimate prescription medications. However, these fake pills often contain lethal amounts of illicit drugs. Distributors in the United States are selling counterfeit pills on social media, appealing to a younger audience that use these apps. Minors and young adults experimenting, as well as regular substance users, believe they are buying authentic oxycodone, Adderall, Xanax, or other medicines, but are unwittingly purchasing counterfeit pills that contain lethal amounts of drugs, usually fentanyl and methamphetamine.
- Classification DTHC or tetrahydrocannabinol is the active ingredient in marijuana that causes users to feel high. The different types of THC are: marijuana, hashish, and sinsemilla.
- Usage/Effects THC is used for both medicinal and illegal purposes. A synthetic THC called Marinol has been used to control nausea and vomiting caused by chemotherapeutic agents used in treatment of cancer and to stimulate the appetite of AIDS patients. Marijuana can be smoked, eaten, drunk, or mixed with other drugs. Some effects of THC include increased heart rate, paranoia, psychosis, respiratory problems, and panic attacks.
K2/Spice and Blue Lotus (Synthetic Cannabinoids)
- Classification Synthetic cannabinoids are part of a group of drugs called new psychoactive substances (NPS). NPS are unregulated mind-altering substances that have become newly available on the market and are intended to produce the same effects as illegal drugs. Some of these substances may have been around for years but have reentered the market in altered chemical forms, or due to renewed popularity.
- K2/Spice is often made of a base of botanical herbs, including blue lotus (a psychoactive plant). The flower’s psychoactive effects are most often attributed to two alkaloids, apomorphine (a sedative) and nuciferine (an antipsychotic). Blue lotus flower can come in many forms like extracts, resins, dried leaves, oils, powders, and electronic cigarette refill liquids (e-liquids). These products are often sold as natural sedatives and/or aphrodisiacs but are not approved by the Federal Drug Administration (FDA) and are still deemed illicit by the Department of Defense.
- Usage/Effects The most common way to use synthetic cannabinoids is to smoke the dried plant material. Users also mix the sprayed plant material with marijuana or brew it as tea. Other users buy synthetic cannabinoid products as liquids to vaporize in e-cigarettes.
- The typical means for consumption of blue lotus often include drinking in teas and dissolving in ethanol-containing beverages (since the alkaloids are not water soluble) or smoking or vaping in electronic cigarettes. Effects are often similar as K2/Spice, but in higher doses can cause intense euphoria and hallucinations, altered mental status (confusion, anxiety, paranoia, etc.), slurred speech, drowsiness, chest pain, and increased heartrate.
- Classification Cocaine is classified as a Central Nervous System Stimulant. In the early 1900s, it became the main stimulant drug used in most of the tonics/elixirs that were developed to treat a wide variety of illnesses. Today, cocaine is a Schedule II drug under the Controlled Substances Act of 1970, meaning that it has high potential for abuse, but can be administered by a doctor for legitimate medical uses, such as local anesthesia for some eye, ear, and throat surgeries.
- Usage/Effects Cocaine can be snorted, boiled in water and injected, eaten, or smoked (crack). Cocaine's effects appear almost immediately after a single dose. The effects of Cocaine include decreased appetite, increased body temperature, increased heart rate, dilated pupils, nausea/vomiting, severe nose damage (when snorted), kidney failure, seizure, and stroke or heart attack.
- Classification MDMA is a Schedule I drug under the Controlled Substances Act, meaning it has a high potential for abuse, no currently accepted medical use in treatment in the United States, and a lack of accepted safety for use under medical supervision. Although MDMA is known among users as ecstasy, researchers have determined that many ecstasy tablets contain not only MDMA but also a number of other drugs or drug combinations that can be harmful, such as methamphetamine, ketamine, cocaine, cathinones, and caffeine.
- Usage/Effects MDMA use mainly involves swallowing tablets (50-150 mg), which are sometimes crushed and snorted, occasionally smoked, but rarely injected. It is also available as a powder. MDMA is considered a “party drug.” As with many other drugs of abuse, MDMA is rarely used alone. It is common for users to mix MDMA with other substances, such as alcohol and marijuana. In addition to altering the serotonin system in the brain (with potential long-term damage), users of MDMA experience many of the same effects and face many of the same risks as users of other stimulants such as cocaine and amphetamines, including increased motor activity, alertness, heart rate, and blood pressure.
- Classification Eutylone is a synthetic cathinone with chemical structural and pharmacological similarities to schedule I and II amphetamines and cathinones such as MDMA, methylone, and pentylone. Evidence indicates that eutylone, like other schedule I synthetic cathinones, is abused for its psychoactive effects.
- Usage/Effects Users have reported administering eutylone by oral, intravenous, and nasal routes. Effects reported by users of eutylone include warm tingling sensations, increased focus, changes in vision, euphoria, and an intense high. In general, synthetic cathinones have been reported to cause a number of stimulant-like adverse effects including tachycardia, hypertension, hyperthermia, palpitations, low blood sodium, tremors, seizures, vomiting, sweating, headache, and rhabdomyolysis.
Hallucinogens (including LSD, mushrooms, and PCP)
- Classification Hallucinogens are among the oldest known group of drugs used for their ability to alter perception and mood. There was a resurgence of these psychedelic drugs in the 1990s associated with other club drugs and raves. Hallucinogens consist of LSD, PCP, Mescaline, and Psilocybin.
- Usage/Effects Hallucinogens such as LSD are usually consumed orally in one of three ways: pill form, a piece of blotter paper, or liquid dripped directly on tongue or sugar cube. Physical effects of all hallucinogens consist of symptoms such as extreme sweating, increased heart rate, increased blood pressure, seizures, vivid hallucinations, bad trips, and flash backs.
- Classification Invisible, volatile substances found in common household products, e.g., felt tip markers, spray paint, air freshener, typewriter correction fluid, butane, computer cleaners, glue and includes more than 1,000 products that are harmful when inhaled.
- Usage/Effects Inhalants are breathed in through the nose or huffed by a soaked rag stuffed in the mouth. Common delivery can be inhaling balloons with nitrous oxide, sniffing or snorting the substance from a container or dispenser, or inhaling fumes from a bag. Effects can include slight stimulation, feeling less inhibition, loss of consciousness, damages sections of brain controlling thinking, moving, seeing, slurred speech, loss of coordination, euphoria, dizziness. Long term use may cause damage to nervous system and organs. Sudden sniffing death may occur from suffocation or asphyxiation.
- Classification Salvia Divinorum is a hallucinogen herb of the mint family. The drug comes in three forms: live plants, dried leaves, and extract as liquid form. Extracted and dried leaves are widely available over the internet, plants are available at nurseries, and can be easily grown as potted plants or in the ground.
- Usage/Effects Salvia Divinorum can be consumed in different forms. It can be ingested by chewing and swallowing, sublingual under the tongue, and smoking a pipe or cigarette. The plant is known to have amnesic effects, unconsciousness, and the inability to recall the experience. There are still many unknown effects of Salvia Divinorum in regards to addiction, health problems, smoking risks, overdose, and physical dangers.
Amphetamines (including methamphetamine)
- Classification Amphetamines are classified as Central Nervous System Stimulants. Amphetamines can be divided into three basic groups: Amphetamines (Benzedrine), Dexamphetamines (Dexedrine), and Methamphetamine s (Methedrine). They are used for both medicinal and illicit purposes. The group includes prescription CNS drugs commonly used to treat attention-deficit hyperactivity disorder (ADHD) in adults and children. It is also used to treat symptoms such as traumatic brain injury and the daytime drowsiness symptoms of narcolepsy. The drug is used illegally as a recreational drug and as a performance enhancer.
- Usage/Effects There are several methods of consuming Amphetamines. These methods of consumption include: oral/ pill or tablet form, injection/ liquid form into the blood stream or muscle tissue, smoking, and snorting. Snorting can cause severe damage to the interior and exterior of the nose.
- The effects of Amphetamines vary from short term to long term usage. Some short-term effects include: dilated pupils, decreased appetite, tremors, and loss of consciousness. Long term effects include malnutrition, chronic psychosis, chronic anxiety/tension, and brain damage.
- Classification Synthetic cathinones, more commonly known as "bath salts," are human-made stimulants chemically related to cathinone, a substance found in the khat plant. Synthetic cathinones are part of a group of drugs that concern public health officials called "new psychoactive substances" (NPS). NPS are unregulated psychoactive mind-altering substances with no legitimate medical use and are made to copy the effects of controlled substances. They are introduced and reintroduced into the market in quick succession to dodge or hinder law enforcement efforts to address their manufacture and sale.
- Synthetic cathinones are marketed as cheap substitutes for other stimulants such as methamphetamine and cocaine, and products sold as Molly (MDMA) often contain synthetic cathinones instead.
- Usage/Effects People typically swallow, snort, smoke, or inject synthetic cathinones.
- Synthetic cathinones can produce effects that include:
- paranoia—extreme and unreasonable distrust of others
- hallucinations—experiencing sensations and images that seem real but are not
- aincreased friendliness
- increased sex drive
- panic attacks
- excited delirium—extreme agitation and violent behavior Source: drugabuse.gov
- Classification Anabolic Steroids are any drug or hormonal substance chemically and pharmacologically related to testosterone that promotes muscle growth. A limited number of anabolic steroids have been approved for medical and veterinary use. These drugs are also illicitly used by weightlifters, body builders, long distance runners, cyclists, and others who claim the drugs give them a competitive edge and improve their physical appearance.
- Usage/Effects Anabolic Steroids can be ingested in a variety of ways: orally in a pill or liquid form, intravenously, injected with the use of a hypodermic needle, and rubbed onto the skin with the steroid in a gel or cream form. Short term effects of steroids include sore throat, bad acne/rashes, chronic headaches, insomnia, nausea, muscle cramps, and bone pain. Some long-term effects include feminine breasts in men, sterility, brain damage, tumors of the liver, hepatitis, liver cancer, eye infections, kidney disease, enlargement of facial bones, heart attacks, and overly aggressive attitude or ‘ROID-RAGE’, homicidal rage.
THC and CBD
Both tetrahydrocannabinol (THC) and cannabidiol (CBD) are two natural compounds found in cannabis (marijuana). Even though they both have the same molecular structure (21 carbon atoms, 30 hydrogen atoms, and 2 oxygen atom), they are arranged differently and have different effects on the human body.
THC gives the “high” and binds to the C1 receptors in the brain. CBD weakly attaches to these same receptors but gives no feeling of euphoria and can dampen the high from THC.
CBD is used to help with other various conditions, such as: seizures, inflammation, pain, psychosis or mental disorders, inflammatory bowel disease, nausea, migraines, depression, and anxiety.
THC is used to help with conditions such as: pain, muscle spasticity, glaucoma, insomnia, low appetite, nausea, anxiety.
Dangers of using medications not prescribed to you and outdated medication.
Everyone’s body chemistry is different. What a doctor prescribes for a friend may not be appropriate for you and vice versa and the outcome could be potentially fatal.
Outdated medication (typically 1 year from the fill date) can be just as dangerous, even though it was initially prescribed for you. Medications can expire, change in chemical composition, and risk bacterial growth. Your body chemistry can also change (including your weight), which could affect the proper dose and potentially yield dangerous outcomes. There could be counterindications with other medications you’re taking, unexpected reactions, or other serious outcomes.